Aims and objectives To explore the effects of introducing a telemonitoring and care planning system for urinary continence assessment in a nursing home and adherence by care staff to urinary continence care plans. Background Only a few studies have explored the effect of introducing telemonitoring system on urinary continence care, none for older people in nursing homes. Design Pre- and postintervention repeated measures design. Methods Data for the study were collected from August-October 2011. Care staff were trained in the use of a telemonitoring system for continence assessment. Voiding events for each older person were recorded using the system during a 72-hour urinary continence assessment, and the data were used to prepare an individualised care plan. After two weeks of using the new care plan, a second assessment was carried out for each older person, using the telemonitoring system. Results The participants were on average 81 years old and assessed as having high care needs. The statistically significant outcomes were as follows: reduced volume of urine voided into continence aids, reduced number of prescribed toileting visits, increased number of actual toilet visits, increased number of successful toileting events and increased adherence to urinary continence care plans by staff. Conclusions During a 12-week trial, urinary continence assessment and management of older people were improved. This suggests that the introduction of a suitably designed telemonitoring system combined with staff training can improve urinary continence care. Relevance to clinical practice The results suggest that nursing homes can improve continence assessment and management practices by adopting an appropriately designed mobile, wireless telemonitoring system for continence assessment and providing the associated staff training programmes.